Reject analysis: a comparison of conventional film–screen radiography and computed radiography with PACS

Abstract Purpose This study was undertaken to investigate and compare the reject rate and causes of rejection between conventional film–screen radiography and computed radiography with PACS in the same radiology department. Methods Rejected radiographs of conventional film–screen radiography were collected over a 12-month period. After the installation of a computed radiography system and picture archiving and communication system (PACS), rejected images were also recorded at the quality assurance workstation for 12 months. The rejected radiographs and images were analyzed and categorized into seven groups according to the causes of rejection. Results The overall reject rate of computed radiography with PACS (1.3%) was significantly lower than that of conventional radiography (2.1%). In conventional radiography, exposure (38.6%) and positioning (28.2%) errors were the main reasons for rejection, whereas the main reason in computed radiography was positioning errors (55.4%). Rejection due to exposure errors and patient movement in computed radiography (7.4% and 2.3%, respectively) are significantly lower than those in conventional radiography (38.6% and 6.5%, respectively). Conclusions With the use of computed radiography and PACS, the overall reject rate is reduced when compared to conventional film–screen radiography. Unnecessary radiation exposure to patients due to image retake can be reduced.